Partners

Suicide rates in the U.S. have increased nearly 30 percent in less than 20 years, the Centers for Disease Control and Prevention reported June 7. These mind-numbing statistics were released the same week two very famous, successful and beloved people committed suicide – Kate Spade, a tremendous entrepreneur, trendsetter and fashion icon, and Anthony Bourdain, a distinguished chef and world traveler who took us on gastronomic journeys to all corners of the world through his TV shows.

Their tragic deaths, and others like them, have brought new awareness to the rapidly growing public health problem of suicide in the U.S. These deaths have renewed the country’s conversation about the scope of the problem. The sad truth is that suicide is the 10th leading cause of death among all Americans, and among youth and young adults, suicide is the third leading cause of death.

I believe it’s time for us to pause and to ask the question why? Why are the suicide rates increasing so fast? And, are the increasing suicide rates linked to the seeming increase in demand for drugs such as marijuana, opioids and psychiatric medicine? As a public health researcher and epidemiologist who has studied these issues for a long time, I think there may be deeper issues to explore.

In our national discussion of this issue, we raise important questions about the potential failure of our mental health system, its infrastructure and the stigma around mental health diagnoses, substance use and treatment. We also talk about the treatment gap, meaning the difference between those who need treatment versus those who can access and get treatment.

These are all valid concerns and critically important to address, but they are only part of the problem. As the CDC pointed out in its report, more than half of the suicide deaths in the U.S. did not have a known diagnosed mental health condition. So, while there are many reasons for raising concerns about our fragmented mental health system, the treatment gap and associated factors, I don’t think it is sufficient to understand our increasing suicide rates. One needs to look more broadly at underlying factors to understand why the suicide rate is increasing so significantly.

Taken together, it seems that the majority of our U.S. population is currently under the influence of some form of psychoactive substance or drug, whether prescribed or not, or whether legally used or not, that changes brain function, mood, consciousness and behavior. And, let’s not forget alcohol in this context since 70 percent of U.S. adults drink alcohol, and more than 1 in 4 binge drink.

What drives the demand for these psychoactive substances? And can the increasing demand and prevalence of both illicit and licit substance help explain the rising rates of suicides?

Research that seeks to understand the reasons for prescription misuse finds that people who report misusing prescription drugs such as tranquilizers do it because they want to relax or relieve tension; those who misuse stimulants state they need to stay alert; and those who misuse sedatives state it helps with sleep.

It is not clear what exactly drives the demand for the psychoactive substances and what has driven the increase in suicides. But I think it’s worth speculating whether a perceived low quality of life for many Americans, marked by high stress and low levels of happiness, is contributing.

Americans stand out from people in other countries with respect to their focus on individualism. Americans believe that success is determined by our own control and that it is very important to work hard to get ahead in life. Perhaps it is this focus on our own achievements, successes and work culture that have created an environment that is no longer sustainable – it has become too stressful.

What other options do we have in a culture where we are also expected to solve our own problems? I believe that for many, the use of substances and suicides may tragically be the only available coping mechanism.